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基于化学发光酶免疫分析法的脑脊液生物标志物对阿尔茨海默病诊断的诊断准确性。

Diagnostic accuracy of cerebrospinal fluid biomarkers measured by chemiluminescent enzyme immunoassay for Alzheimer disease diagnosis.

机构信息

Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy.

Unit of Neurology, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy.

出版信息

Scand J Clin Lab Invest. 2020 Jul;80(4):313-317. doi: 10.1080/00365513.2020.1740939. Epub 2020 Apr 7.

Abstract

In the last decades, an important role of cerebrospinal fluid (CSF) biomarkers for Alzheimer disease (AD) diagnosis has emerged. The evaluation of the triad consisting of 42 aminoacid-long amyloid-beta peptide (Aβ42), total Tau (tTau) and Tau phosphorylated at threonine 181 (pTau) have been recently integrated into the research diagnostic criteria of AD. For a long time, the enzyme-linked immunosorbent assay (ELISA) has represented the most commonly used method for the measurement of CSF biomarkers levels. This study aimed to assess the diagnostic accuracy of CSF biomarkers, namely Aβ42, tTau and pTau and their ratio, measured by fully automated CLEIA assay (Lumipulse). We included 96 patients clinically diagnosed as AD (48) and non-AD (48). All CSF biomarkers levels were measured on Lumipulse G1200 fully automated platform (Fujirebio Inc. Europe, Gent, Belgium). Aβ42 levels, 42/40 ratio, 42/tTau ratio, 42/PTau ratio were significantly reduced, and tTau and PTau levels were significantly increased in AD patients in comparison with non-AD patients. The receiving operator curve (ROC) analysis showed good diagnostic accuracy of all CSF biomarkers and their ratios for discriminating AD patients from non-AD patients, with 42/40 ratio having the best AUC (0.724, 95%CI 0.619-0.828;  < 0.001). Our findings support the use of CSF biomarkers measured by CLEIA method on a fully automated platform for AD diagnosis.

摘要

在过去的几十年中,脑脊液(CSF)生物标志物在阿尔茨海默病(AD)诊断中的重要作用已经显现出来。最近,三肽组合(42 个氨基酸长的淀粉样蛋白-β肽(Aβ42)、总 Tau(tTau)和 Tau 在苏氨酸 181 位磷酸化(pTau))的评估已被纳入 AD 的研究诊断标准。长期以来,酶联免疫吸附测定(ELISA)一直是测量 CSF 生物标志物水平最常用的方法。本研究旨在评估 CSF 生物标志物(即 Aβ42、tTau 和 pTau 及其比值)的诊断准确性,这些标志物由全自动 CLEIA 测定法(Lumipulse)测量。我们纳入了 96 名临床诊断为 AD(48 名)和非 AD(48 名)的患者。所有 CSF 生物标志物水平均在 Lumipulse G1200 全自动平台(Fujirebio Inc. Europe,Gent,Belgium)上进行测量。与非 AD 患者相比,AD 患者的 Aβ42 水平、42/40 比值、42/tTau 比值和 42/pTau 比值显著降低,tTau 和 pTau 水平显著升高。接受者操作特征曲线(ROC)分析显示,所有 CSF 生物标志物及其比值区分 AD 患者和非 AD 患者的诊断准确性良好,其中 42/40 比值的 AUC 最佳(0.724,95%CI 0.619-0.828; < 0.001)。我们的研究结果支持在 AD 诊断中使用 CLEIA 方法在全自动平台上测量 CSF 生物标志物。

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